Saturday , November 28 2020

Screening service in & # 39; meltdown & # 39; as more women participate in smears | Community



Women may be forced to wait months on cervical screening results because the planned closure of dozens of laboratories has left the service in "meltdown", the Guardian has been told.

The crisis has been triggered by an increase in the number of women taking part in smear tests for a public public awareness campaign launched last week. The campaign coincides with an exodus of biomedical scientists due to a restructuring process that will reduce nearly 50 hospital screening laboratories to nine this summer.

Alison Cropper, chairman of the British Association for Cytopathology and a biomedical consultant, said that Public Health England's campaign had been launched in "the worst time that might have been".

"The service is down," she said.

Although the quality of testing is unlikely to be affected, she said "poorly thought out" timing of the campaign risks leaving women frustrated, unfairly anxious, and less likely to engage in screening in the future. Cropper said the PHE had not complied with requests to change the wording of standard screening letters, which recommends that the results be sent within 14 days, although warned that some laboratories are already facing months ago.

The government launched its first ever cervical screening campaign last week after official figures revealed that the proportion of women participating in the test is at 20 years low. Cervical screenings, also known as smear tests, are free on the NHS for all women aged 25-64. Labs have reported a sharp increase in workload over the last two months following the launch of the PHE campaign and other publications, including a Coronation Street storyline and a woman with a live smear test on the BBC's Victoria Derbyshire program.

However, the increase in admission has come as many researchers leave after a decision to centralize the screening system.

Traditionally, smear tests have seen abnormal changes in the cervical cells, which could indicate the earliest stages of cancer. Samples showing possible low grade changes are tested for human papillomavirus (HPV), which causes almost all cases of cervical cancer. Those who have low-grade changes and HPV are then referred to additional tests (a colposcopy).

However, the research has shown that switching the laboratory screen sequence and testing HPV first detects precarious lesions more effectively. Later this year, the NHS will move to an HPV first test system, which is also less labor intensive, and it will centralize work from nearly 50 laboratories to nine major centers to be described next month.

Meanwhile, many researchers in smaller laboratories who have not requested contracts under the new system have little incentive to remain until the transfer.

A senior biomedical scientist at a small hospital lab that will be closed later this year told the Guardian that nearly half of the staff had left at a time when the number of samples entering the lab had risen five times. A whiteboard in the lab's tearoom, which usually shows a number of samples in each week, now reads "parties", she said. "We break the patient's interrupted time, the doctors get nervous, nurses ask us what the hell is going on," said the researcher, who will remain anonymous. "It's a complete shambles."

Cropper said that "no one in business" would disagree with the decision to move to the HPV first test, but that implementation had not been thought through. "In the smaller laboratories, one or two people who leave or leave sick with stress have a disastrous effect," she said.

Prof Anne Mackie, director of screening at Public Health England, said: "Screening can stop cancer before it starts and estimates show that if everyone participated regularly, 83% of deaths could be prevented. Since the program started estimating 5,000 lives a year , there have been rescues, but cervical screening numbers are 20 years old, so we introduced this campaign.

"Delays in women who get their results are far from what we want, but it is important that women still get the test to identify abnormalities that can develop into cancer years later.

"We worked closely with the NHS England to ensure that the screening system was given prior notice. It is more important that we increase the number of women being screened and prevent more lives from being lost than the delay further, which is long. waited. "


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